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Bronchoalveolar Lavage in Subjects Exposed to Occupational Dusts.

Bronchoalveolar responses to inhaled occupational dusts were studied in a cohort of eight healthy electric power station workers exposed to fly ash, one healthy coal miner, and one rock driller being treated for acute silicosis. All were lifetime nonsmokers except for one power station worker who was a former smoker. The comparisons were eight males with no history of occupational dust exposure; two of whom were exsmokers. The mean ages of the cohort and comparisons were 38 and 36 years, respectively. Bronchoalveolar lavage was performed and analyzed for total numbers of alveolar macrophages, lymphocytes, and neutrophils. The secretory activity of the macrophages was evaluated by measuring resting and zymosan and phorbol-12-myristate-acetate (PMA) stimulated chemiluminescence. Fly ash caused significant increases in lavage fluid alveolar macrophage, lymphocyte, and neutrophil counts relative to the comparisons. Resting and PMA and zymosan stimulated macrophage chemiluminescence was increased. The increase in zymosan stimulated chemiluminescence was statistically significant. Coal dust caused only a slight increase in resting chemiluminescence. Lavage fluid from the silicotic subject contained significantly elevated lymphocyte and neutrophil counts. Resting and PMA and zymosan stimulated macrophage chemiluminescence was significantly increased. The authors conclude that asymptomatic persons with occupational dust exposures demonstrate significant changes in lavage fluid cell populations and macrophage phagocytic activity compared to unexposed individuals. These changes are more pronounced in silicotics.